Lack of microbiological awareness on the ward as a key factor for inappropriate use of anti-infectives: results of a point prevalence study and user satisfaction survey in a large university hospital in Austria
Purpose Although diagnostic stewardship issues in clinical microbiology harbor an optimization potential for anti-infective consumption, they are only marginally addressed in antimicrobial stewardship (AMS) programs. As part of an AMS point prevalence (PPS) survey we therefore aimed to gain a more d...
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Veröffentlicht in: | Infection 2024-06, Vol.52 (3), p.995-1008 |
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creator | Kern, Jan Marco Berger, Karoline Lechner, Arno Michael Porsche, Ulrike Wallner, Markus Past, Eva Maria |
description | Purpose
Although diagnostic stewardship issues in clinical microbiology harbor an optimization potential for anti-infective consumption, they are only marginally addressed in antimicrobial stewardship (AMS) programs. As part of an AMS point prevalence (PPS) survey we therefore aimed to gain a more dynamic view on the microbiological awareness within therapeutic regimens. By examining whether initial microbiological sampling was performed and in which way microbiological results were incorporated into further treatment considerations we sought to find out to what extent these points determine the appropriateness of treatment regimens.
Methods
PPS was performed at the University Hospital Salzburg (1524 beds) in May 2021. Relevant data was determined from the patient charts and the appropriateness of anti-infective use was assessed using predefined quality indicators. Six months after the PPS, a questionnaire was administered to clinicians to obtain information on the use of microbiological findings and their relevance in the clinic.
Results
Lack of microbiological awareness in the clinical setting proved to be the key reason for an overall inadequate use of anti-infectives (35.4% of cases rated as inadequate), ahead of the aspects of dose (24.1%), empirical therapy (20.3%) and treatment duration (20.2%). This was particularly the case for broad-acting agents and was most evident in urinary tract infections, skin and soft tissue infections, and pneumonia. The results of the questionnaire indicate a discrepancy between the physicians surveyed and the routine clinical setting.
Conclusion
A high potential in improving the use of anti-infectives in hospitals seems to lie in a strong emphasis on microbiological diagnostic stewardship measures. |
doi_str_mv | 10.1007/s15010-023-02150-4 |
format | Article |
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Although diagnostic stewardship issues in clinical microbiology harbor an optimization potential for anti-infective consumption, they are only marginally addressed in antimicrobial stewardship (AMS) programs. As part of an AMS point prevalence (PPS) survey we therefore aimed to gain a more dynamic view on the microbiological awareness within therapeutic regimens. By examining whether initial microbiological sampling was performed and in which way microbiological results were incorporated into further treatment considerations we sought to find out to what extent these points determine the appropriateness of treatment regimens.
Methods
PPS was performed at the University Hospital Salzburg (1524 beds) in May 2021. Relevant data was determined from the patient charts and the appropriateness of anti-infective use was assessed using predefined quality indicators. Six months after the PPS, a questionnaire was administered to clinicians to obtain information on the use of microbiological findings and their relevance in the clinic.
Results
Lack of microbiological awareness in the clinical setting proved to be the key reason for an overall inadequate use of anti-infectives (35.4% of cases rated as inadequate), ahead of the aspects of dose (24.1%), empirical therapy (20.3%) and treatment duration (20.2%). This was particularly the case for broad-acting agents and was most evident in urinary tract infections, skin and soft tissue infections, and pneumonia. The results of the questionnaire indicate a discrepancy between the physicians surveyed and the routine clinical setting.
Conclusion
A high potential in improving the use of anti-infectives in hospitals seems to lie in a strong emphasis on microbiological diagnostic stewardship measures.</description><identifier>ISSN: 0300-8126</identifier><identifier>ISSN: 1439-0973</identifier><identifier>EISSN: 1439-0973</identifier><identifier>DOI: 10.1007/s15010-023-02150-4</identifier><identifier>PMID: 38150152</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Anti-Infective Agents - therapeutic use ; Antiinfectives and antibacterials ; Antimicrobial Stewardship ; Austria - epidemiology ; Clinical microbiology ; Diagnostic systems ; Family Medicine ; Female ; General Practice ; Health services ; Hospitals ; Hospitals, University ; Humans ; Inappropriate Prescribing - statistics & numerical data ; Infectious Diseases ; Internal Medicine ; Male ; Medicine ; Medicine & Public Health ; Microbiology ; Middle Aged ; Prevalence ; Questionnaires ; Soft tissues ; Surveys ; Surveys and Questionnaires ; Urinary tract ; User satisfaction</subject><ispartof>Infection, 2024-06, Vol.52 (3), p.995-1008</ispartof><rights>The Author(s) 2023</rights><rights>2023. The Author(s).</rights><rights>The Author(s) 2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c426t-b0d1bd6b17893b9e6d3dfc03ed6a8fa77bdc537bb87f18f4ed4cdc0893c3eb203</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s15010-023-02150-4$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s15010-023-02150-4$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38150152$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kern, Jan Marco</creatorcontrib><creatorcontrib>Berger, Karoline</creatorcontrib><creatorcontrib>Lechner, Arno Michael</creatorcontrib><creatorcontrib>Porsche, Ulrike</creatorcontrib><creatorcontrib>Wallner, Markus</creatorcontrib><creatorcontrib>Past, Eva Maria</creatorcontrib><title>Lack of microbiological awareness on the ward as a key factor for inappropriate use of anti-infectives: results of a point prevalence study and user satisfaction survey in a large university hospital in Austria</title><title>Infection</title><addtitle>Infection</addtitle><addtitle>Infection</addtitle><description>Purpose
Although diagnostic stewardship issues in clinical microbiology harbor an optimization potential for anti-infective consumption, they are only marginally addressed in antimicrobial stewardship (AMS) programs. As part of an AMS point prevalence (PPS) survey we therefore aimed to gain a more dynamic view on the microbiological awareness within therapeutic regimens. By examining whether initial microbiological sampling was performed and in which way microbiological results were incorporated into further treatment considerations we sought to find out to what extent these points determine the appropriateness of treatment regimens.
Methods
PPS was performed at the University Hospital Salzburg (1524 beds) in May 2021. Relevant data was determined from the patient charts and the appropriateness of anti-infective use was assessed using predefined quality indicators. Six months after the PPS, a questionnaire was administered to clinicians to obtain information on the use of microbiological findings and their relevance in the clinic.
Results
Lack of microbiological awareness in the clinical setting proved to be the key reason for an overall inadequate use of anti-infectives (35.4% of cases rated as inadequate), ahead of the aspects of dose (24.1%), empirical therapy (20.3%) and treatment duration (20.2%). This was particularly the case for broad-acting agents and was most evident in urinary tract infections, skin and soft tissue infections, and pneumonia. The results of the questionnaire indicate a discrepancy between the physicians surveyed and the routine clinical setting.
Conclusion
A high potential in improving the use of anti-infectives in hospitals seems to lie in a strong emphasis on microbiological diagnostic stewardship measures.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anti-Infective Agents - therapeutic use</subject><subject>Antiinfectives and antibacterials</subject><subject>Antimicrobial Stewardship</subject><subject>Austria - epidemiology</subject><subject>Clinical microbiology</subject><subject>Diagnostic systems</subject><subject>Family Medicine</subject><subject>Female</subject><subject>General Practice</subject><subject>Health services</subject><subject>Hospitals</subject><subject>Hospitals, University</subject><subject>Humans</subject><subject>Inappropriate Prescribing - statistics & numerical data</subject><subject>Infectious Diseases</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Microbiology</subject><subject>Middle Aged</subject><subject>Prevalence</subject><subject>Questionnaires</subject><subject>Soft tissues</subject><subject>Surveys</subject><subject>Surveys and Questionnaires</subject><subject>Urinary tract</subject><subject>User satisfaction</subject><issn>0300-8126</issn><issn>1439-0973</issn><issn>1439-0973</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9Uktv1DAQjhCILoU_wAFZ4sIlYMfZOOGCqoqXtBIXOFuOPdl1m7WDx9lq_ya_iEm3lMeBg2Vb8z1m7K8ongv-WnCu3qBYc8FLXkladC7rB8VK1LIreafkw2LFJedlK6rmrHiCeMU5X3e1elycyXahrqtV8WNj7DWLA9t7m2Lv4xi33pqRmRuTIAAii4HlHTC6O2aQGXYNRzYYm2NiAy0fzDSlOCVvMrAZYZEzIfvShwFs9gfAtywBzmPG2xqbog-ZTQkOZoRggWGe3ZFIbuEnhiZ7XCw8meOcDuToAxFHk7bkEUgzoc9Htos4-Uz9UvlixkxNPC0eDWZEeHa3nxffPrz_evmp3Hz5-PnyYlPaumpy2XMnetf0QrWd7DtonHSD5RJcY9rBKNU7u5aq71s1iHaowdXWWU5gK6GvuDwv3p10p7nfg7MQcjKjpnfYm3TU0Xj9dyX4nd7GgxaCPonzjhRe3Smk-H0GzHrv0cI4mgBxRl11vFGqbmRF0Jf_QK_inALNpyVvKtWqqhaEqk4o-kvEBMN9N4LrJTP6lBlNmdG3mdE1kV78Occ95VdICCBPAKRS2EL67f0f2Z-5HtOW</recordid><startdate>20240601</startdate><enddate>20240601</enddate><creator>Kern, Jan Marco</creator><creator>Berger, Karoline</creator><creator>Lechner, Arno Michael</creator><creator>Porsche, Ulrike</creator><creator>Wallner, Markus</creator><creator>Past, Eva Maria</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20240601</creationdate><title>Lack of microbiological awareness on the ward as a key factor for inappropriate use of anti-infectives: results of a point prevalence study and user satisfaction survey in a large university hospital in Austria</title><author>Kern, Jan Marco ; Berger, Karoline ; Lechner, Arno Michael ; Porsche, Ulrike ; Wallner, Markus ; Past, Eva Maria</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c426t-b0d1bd6b17893b9e6d3dfc03ed6a8fa77bdc537bb87f18f4ed4cdc0893c3eb203</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anti-Infective Agents - therapeutic use</topic><topic>Antiinfectives and antibacterials</topic><topic>Antimicrobial Stewardship</topic><topic>Austria - epidemiology</topic><topic>Clinical microbiology</topic><topic>Diagnostic systems</topic><topic>Family Medicine</topic><topic>Female</topic><topic>General Practice</topic><topic>Health services</topic><topic>Hospitals</topic><topic>Hospitals, University</topic><topic>Humans</topic><topic>Inappropriate Prescribing - statistics & numerical data</topic><topic>Infectious Diseases</topic><topic>Internal Medicine</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Microbiology</topic><topic>Middle Aged</topic><topic>Prevalence</topic><topic>Questionnaires</topic><topic>Soft tissues</topic><topic>Surveys</topic><topic>Surveys and Questionnaires</topic><topic>Urinary tract</topic><topic>User satisfaction</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kern, Jan Marco</creatorcontrib><creatorcontrib>Berger, Karoline</creatorcontrib><creatorcontrib>Lechner, Arno Michael</creatorcontrib><creatorcontrib>Porsche, Ulrike</creatorcontrib><creatorcontrib>Wallner, Markus</creatorcontrib><creatorcontrib>Past, Eva Maria</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Infection</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kern, Jan Marco</au><au>Berger, Karoline</au><au>Lechner, Arno Michael</au><au>Porsche, Ulrike</au><au>Wallner, Markus</au><au>Past, Eva Maria</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Lack of microbiological awareness on the ward as a key factor for inappropriate use of anti-infectives: results of a point prevalence study and user satisfaction survey in a large university hospital in Austria</atitle><jtitle>Infection</jtitle><stitle>Infection</stitle><addtitle>Infection</addtitle><date>2024-06-01</date><risdate>2024</risdate><volume>52</volume><issue>3</issue><spage>995</spage><epage>1008</epage><pages>995-1008</pages><issn>0300-8126</issn><issn>1439-0973</issn><eissn>1439-0973</eissn><abstract>Purpose
Although diagnostic stewardship issues in clinical microbiology harbor an optimization potential for anti-infective consumption, they are only marginally addressed in antimicrobial stewardship (AMS) programs. As part of an AMS point prevalence (PPS) survey we therefore aimed to gain a more dynamic view on the microbiological awareness within therapeutic regimens. By examining whether initial microbiological sampling was performed and in which way microbiological results were incorporated into further treatment considerations we sought to find out to what extent these points determine the appropriateness of treatment regimens.
Methods
PPS was performed at the University Hospital Salzburg (1524 beds) in May 2021. Relevant data was determined from the patient charts and the appropriateness of anti-infective use was assessed using predefined quality indicators. Six months after the PPS, a questionnaire was administered to clinicians to obtain information on the use of microbiological findings and their relevance in the clinic.
Results
Lack of microbiological awareness in the clinical setting proved to be the key reason for an overall inadequate use of anti-infectives (35.4% of cases rated as inadequate), ahead of the aspects of dose (24.1%), empirical therapy (20.3%) and treatment duration (20.2%). This was particularly the case for broad-acting agents and was most evident in urinary tract infections, skin and soft tissue infections, and pneumonia. The results of the questionnaire indicate a discrepancy between the physicians surveyed and the routine clinical setting.
Conclusion
A high potential in improving the use of anti-infectives in hospitals seems to lie in a strong emphasis on microbiological diagnostic stewardship measures.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>38150152</pmid><doi>10.1007/s15010-023-02150-4</doi><tpages>14</tpages><oa>free_for_read</oa></addata></record> |
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source | MEDLINE; Springer Journals |
subjects | Adult Aged Aged, 80 and over Anti-Infective Agents - therapeutic use Antiinfectives and antibacterials Antimicrobial Stewardship Austria - epidemiology Clinical microbiology Diagnostic systems Family Medicine Female General Practice Health services Hospitals Hospitals, University Humans Inappropriate Prescribing - statistics & numerical data Infectious Diseases Internal Medicine Male Medicine Medicine & Public Health Microbiology Middle Aged Prevalence Questionnaires Soft tissues Surveys Surveys and Questionnaires Urinary tract User satisfaction |
title | Lack of microbiological awareness on the ward as a key factor for inappropriate use of anti-infectives: results of a point prevalence study and user satisfaction survey in a large university hospital in Austria |
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